Congress Examines Pharmacy Benefit Managers in Push to Lower Drug Costs

Lawmakers scrutinize PBMs' role in rising drug prices, as bipartisan reform efforts face challenges from lobbying and legislative gridlock.

House Energy and Commerce Committee held a hearing to address pharmacy benefit managers' (PBMs) practices and their impact on prescription drug prices.
PBMs, which negotiate drug rebates and manage insurance pricing, control 80% of U.S. prescriptions through three major companies, raising concerns about market concentration and anti-competitive practices.
Proposed reforms include banning spread pricing, mandating full rebate pass-through to consumers, and requiring divestment from vertically integrated pharmacy businesses.
Critics argue that PBMs and pharmaceutical companies both contribute to high drug costs, with PBMs accused of retaining savings and drugmakers blamed for setting high list prices.
Legislative efforts to reform PBMs have stalled in Congress, with bipartisan support tempered by lobbying influence and broader political disagreements over healthcare policies.